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在线尊严疗法:为绝症患者试行一种在线心理社会干预措施。

Dignity therapy online: Piloting an online psychosocial intervention for people with terminal illness.

作者信息

Bentley Brenda, O'Connor Moira, Williams Anne, Breen Lauren J

机构信息

College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.

School of Psychology, Curtin University, Perth, Australia.

出版信息

Digit Health. 2020 Sep 20;6:2055207620958527. doi: 10.1177/2055207620958527. eCollection 2020 Jan-Dec.

Abstract

OBJECTIVE

Dignity therapy is a life review intervention shown to reduce distress and enhance the quality of life for people with a terminal illness and their families. Dignity therapy is not widely used in clinical practice because it is time and cost prohibitive. This pilot study examined the feasibility and acceptability of dignity therapy delivered through therapist-supported web-based delivery to reduce costs, increase time efficiency, and promote access to treatment.

METHODS

This study employed a one-group pre-test post-test design to pilot methods. Australian adults diagnosed with a terminal illness with a prognosis of six months or less were recruited for the study. The primary outcome measure was a Participant Feedback Questionnaire used in previous face-to-face dignity therapy studies. Data regarding therapist time and details about final documents were recorded.

RESULTS

Six people were recruited; four chose to complete the intervention via videoconference and two chose email. Participants reported high levels of acceptability and efficacy comparable to face-to-face delivery; meanwhile therapist time was about 40% less and legacy documents were longer. Participants described dignity therapy online as convenient, but technological issues may create challenges.

CONCLUSIONS

Online delivery of dignity therapy is feasible and acceptable, reduces therapist time and clinical cost, and appears to reach people who would not otherwise receive the therapy. Dignity therapy via email may have the greatest potential to reduce time and cost barriers. This pilot study demonstrates a need for further research to determine the full benefits of online delivery of dignity therapy.

摘要

目的

尊严疗法是一种生命回顾干预措施,已被证明可减轻临终患者及其家人的痛苦并提高生活质量。尊严疗法在临床实践中未得到广泛应用,因为其耗时且成本高昂。这项试点研究考察了通过治疗师支持的网络交付方式提供尊严疗法的可行性和可接受性,以降低成本、提高时间效率并促进治疗的可及性。

方法

本研究采用单组前后测设计来试点方法。招募了被诊断为患有预后为六个月或更短时间的晚期疾病的澳大利亚成年人参与该研究。主要结局指标是先前面对面尊严疗法研究中使用的参与者反馈问卷。记录了有关治疗师时间的数据以及最终文件的详细信息。

结果

招募了六个人;四人选择通过视频会议完成干预,两人选择电子邮件。参与者报告的可接受性和疗效水平与面对面交付相当;与此同时,治疗师时间减少了约40%,遗留文件更长。参与者将在线尊严疗法描述为方便,但技术问题可能会带来挑战。

结论

在线提供尊严疗法是可行且可接受的,减少了治疗师时间和临床成本,并且似乎能够惠及那些否则无法接受该疗法的人群。通过电子邮件进行尊严疗法可能在减少时间和成本障碍方面具有最大潜力。这项试点研究表明需要进一步研究以确定在线提供尊严疗法的全部益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5deb/7509717/2fe708bb0faa/10.1177_2055207620958527-fig1.jpg

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